Repurposing an “Old” Drug for a New Anti-Tuberculosis Regimen

The combination of meropenem and amoxicillin-clavulanic acid shows a strong bactericidal activity in early phases of treatment


A study published in the New England Journal of Medicine provides scientific evidence for a strong anti-tuberculosis activity of meropenem (a beta-lactam antibiotic) when used in combination with amoxicillin and clavulanic acid. Dr. Alberto García-Basteiro, researcher at ISGlobal, and Dr. Esperança Sevene, from the Manhiça Health Research Center (CISM), participated in the study that points the way towards the development of new therapeutic tools to tackle the growing threat of multi-drug resistant tuberculosis. 

The study rises from the urgent need to develop new treatments to treat the growing number of multi-drug resistant tuberculosis (TB) cases. While new drugs are developed, an alternative is to test new combinations of existing drugs. With this in mind, the authors of the study, coordinated by Dr. Andreas Diacon from the Stellenbosch University in South Africa, tested the efficacy of meropenem, a beta lactam antibiotic with a high safety profile and frequently used in the treatment of other bacterial infections. It was thought that such antibiotics were not useful for treating TB. However, the results of the clinical trial performed on 30 patients showed that the combination of meropenem with amoxicillin and clavulanic acid results in a synergistic bactericidal activity during the first two weeks of treatment, comparable to that observed with the most commonly used drugs for TB treatment. 

“We now need to confirm these data with larger studies, show that they also contribute to the clinical cure of TB, and test other beta lactam antibiotics that can be administered orally so they can be used outside the hospital”, Dr. Garcia Basteiro points out.

The study, funded by the European and Developing Countries Clinical Trial Partnership (EDCTP), has also strengthened the technical and laboratory capacities in the CISM for the evaluation of anti-tuberculosis drugs during their first phases of clinical development. 

Multi-drug resistant TB is a major public health problem that threatens progress made in control and treatment of the disease. It is the result of antibiotic misuse and can be transmitted to other individuals. According to WHO estimates, around 1.5 million people died from TB in 2014, of which 190,000 suffered from multi-drug resistant TB.


Andreas H. Diacon, Lize van der Merwe, Marinus Barnard, Christoph Lange, Alberto L. García-Basteiro, Esperança Sevene, Lluís Ballell. β-Lactams against TB — New Trick for an Old Dog? July 13, 2016. DOI: 10.1056/NEJMc1513236

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